How to deal with back pain from sitting too long

Back and Neck
Young woman wincing at back pain from sitting at kitchen table and working

What started out as two weeks turned into two months and then became an indefinite work from home reality for many. Yet few of the remote workforce were prepared for the physical effects of a work from home lifestyle and may not have put in place the best supports for the body, especially the back.

Back pain from sitting too long is a common concern that ties in with joint mobility, muscle strength and function, and even breathing, so it's important that people who are working from home be proactive about their physical form while working.

Beyond ergonomic seating and 90-degree angles

Many of us are way past the lectures about the ideal ergonomic seating and how we shouldn't be working in bed or how the feet need to be planted on the floor and everything should be at a certain angle. Let's be real: Depending on people's living situations, most of us are playing some version of musical chairs from dining room to kitchen table followed by a stint in the living room easy chair and an afternoon sprawl in the bed. Given the abnormal demands, it's no wonder working from home can sometimes be a pain in the back.

Sitting for long periods of time creates a perfect storm of strain that includes joint misalignment and muscle weakness," explains Scott A. Rushton, MD, an orthopaedic surgeon at Lankenau Medical Center, part of Main Line Health.

"It starts with the constant relaxation and weakening of the hip flexors, the connecting muscles from the top of the thighs to the hips, which in turn control the pelvis and the lumbar spine, therefore putting your back under constant strain. Which then causes the hamstring muscles to reach up and compensate, and that weakens the gluteal muscles that are meant to stabilize the back and pelvis. Sitting is just a whole recipe for back pain—period."

Sitting leads to 40 to 90 percent more stress on the back (disc pressure) than standing posture. – Cornell University Ergonomics Web

Preventing back pain from sitting too long

Instead of worrying about all the ways you're doing it "wrong," consider a few tweaks to your posture or routine here and there because the reality is you're going to have days where you forget to get up and move around or you have a lot more work than usual.

Here are some easy changes you can make to avoid back pain from sitting too long:

Slouching vs. hunching, posture vs. holding erect: Often times we're told not to slouch because it's "bad posture" but it is natural for the spine to curve and for us to bend over our work at times; for example, looking at something while sitting up in bed. What is not natural is for us to hold that position for long periods of time. The same goes for sitting at a computer desk or a dining room table and thinking we have to keep our shoulders back and everything upright. This causes the muscles in the neck and lower back to work extra hard to keep everything in place, again putting too much tension for a long period of time.

"I'd be more concerned about getting up and moving at least every 30 minutes," says Dr. Rushton. "This allows your spine to lengthen and gets the blood flowing to all of the extremities. I recommend taking at least a five-minute break to just stretch. For example, go to a doorway and do a shoulder stretch, placing both hands on either side of the door frame. For the lower back, you can do a gentle hamstring stretch just bending the knees and folding down slowly, even halfway, but don't overdo this or you could have more pain in the glutes and hams. Then just go do something that relieves stress and is good for you. That's what people need to be doing while working from home anyway."

Laptop accessories: If you're still fiddling around with that touchpad, it's time to get a separate keyboard, mouse and lap desk. Bringing the equipment to you—and not vice versa—allows you to sit up straighter when you're not hunched over your laptop. (A word to the wise: Don't be tempted by keyboard wrist rests with gel. These gel inserts can compress or cut off blood flow to the finger flexor tendons and can lead to carpal tunnel problems.

Voice text on computer: You could be saving yourself a lot of wrist strain by using your voice-activated texting and even document creation. You can train Windows 10 to better understand your voice, for example, and Google speech-to-text uses Google Docs to capture and transcribe an audio file. Don't count on the transcriptions being 100 percent accurate, but surely could save time and spare you some carpal tunnel syndrome.

Hold phone at eye level for texting: You've heard about making sure your laptop or computer screen is at eye level, but what about your mobile device? Make a point of holding your phone up at eye level for texting and watching. This will ensure that your neck muscles aren't being unnecessarily strained or put into an awkward position. And if you find that it's too difficult to hold the device at eye level for that length of time, it might be time to put the device down for a break!

Standing desk, dual monitor stand, articulating arm: If you've got the space and the office setup to accommodate it, maybe it's time for the whole works. A standing desk will encourage you to alternate standing and sitting and shifting weight from side to side. Having a dual monitor eases the frustration of having to go back and forth between screens with mouse clicks and an arm could position things exactly the way you want them, every moment of every day. It's certainly worth considering if back pain from sitting too long has become a problem for you.

Yoga sitting and stretching: You don't have to be into yoga to leverage some of its benefits. If you're working on the bed or on a sofa, for example, and you're limber enough to get into a butterfly position (heels touching and pulled in with knees out to sides), this position naturally lifts the weight up off of the body, lengthening the spine and relieving the vertebral discs. It has the added benefit of stretching the inner thighs, groin and knees, and relieves sciatic pain as well.

See an orthopaedic surgeon: This doesn't need to be your first resort but you don't have to keep toughing it out if back pain from sitting too long has gotten so bad that you can't find relief from over-the-counter anti-inflammatories or an ice pack here and there. Orthopaedic surgeons offer both surgical and nonsurgical treatments for back pain. Nonsurgical treatments include lumbar sympathetic blocks and lumbar radiofrequency neurotomy. More complex surgical procedures of the spine may include herniated or degenerated disc treatment, spinal stenosis, spinal deformity, and any kind of spinal reconstructive or revision surgery.

Adds Rushton, "We'd rather see you before it gets to that point so if you have ongoing pain that's concerning you, or you had a pre-existing back issue or sciatica that's worsened now that you're working from home, just make an appointment and come see us. It doesn't hurt to get some diagnostic work done and see what's going on. With a few lifestyle changes and a combination of treatments (and medications if needed), we're often able to resolve back pain issues before they become more serious."

Next steps:

Make an appointment with Scott A. Rushton, MD
Learn more about orthopaedic surgery and orthopaedics at Main Line Health 
How do you know it's time for joint replacement?

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